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Diagnosis

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Brain MRI Findings - 70-year-old Patient

Patient Details

  • Name: Chandrawati / Chanuli
  • Age: 70 years
  • System: United Imaging MRI
  • Sequences visible: T2 FSE, T2 FLAIR, DWI, T1, SWI (susceptibility-weighted), Post-Contrast T1

Key Imaging Findings

1. Confluent Periventricular & Deep White Matter Hyperintensities (FLAIR)
  • Prominent, bilateral, symmetric confluent signal hyperintensity surrounding the lateral ventricles
  • Extending into deep subcortical white matter (centrum semiovale)
  • Consistent with Fazekas Grade 3 - severe chronic small vessel ischemic disease (leukoaraiosis / cerebral microangiopathy)
2. Diffuse Cerebral Atrophy
  • Generalized ventriculomegaly (lateral ventricles and 3rd ventricle enlarged symmetrically)
  • Prominent sulcal widening and sylvian fissure enlargement
  • Likely ventriculomegaly ex vacuo (secondary to parenchymal volume loss)
3. Enlarged Perivascular (Virchow-Robin) Spaces
  • Prominent in the basal ganglia bilaterally
  • Further marker of chronic small vessel disease
4. No acute findings visible:
  • No midline shift or mass effect
  • No gross acute infarct on available sequences (DWI was acquired - final read needed)

Radiological Diagnosis

Chronic Small Vessel Ischemic Disease (Cerebral Microangiopathy) - Severe Grade with Diffuse Cerebral Atrophy
This pattern in a 70-year-old is strongly associated with:
  • Chronic hypertension (most common cause)
  • Diabetes mellitus
  • Hyperlipidemia / metabolic syndrome
Clinically, this correlates with:
  • Vascular cognitive impairment or dementia
  • Gait disturbance
  • Urinary symptoms (subcortical frontal involvement)
  • Depression / apathy
Disclaimer: This is an AI-assisted image analysis for educational/informational purposes only. Final radiological diagnosis must be made by a qualified radiologist reviewing full DICOM images. Clinical correlation is required.
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